AMA diagnoses a bulk-bill bust

Labor must be open to ‘reconsidering their strategy’ on the cornerstone election promise to boost bulk-billing rates across the country, the nation’s peak medical body says.

The Australian Medical Association says while the pool of federal funding for the primary health sector was welcome, the funds should have been used in a different way. Picture: Kevin Farmer

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Labor must be open to “reconsidering their strategy” on the cornerstone election promise to boost bulk-billing rates across the country after Health Department warnings that a quarter of doctors’ clinics would not take up the incentive, the nation’s peak medical body says.

Anthony Albanese claimed frequently throughout the election that Australians should need only a “Medicare card, not a credit card” to see a doctor and vowed that by 2030 nine out of 10 GP ­visits would be free thanks to an $8.5bn injection in Medicare – the biggest funding commitment to the scheme in 40 years.

The Australian Medical Association said while the pool of federal funding for the primary health sector was welcome, the funds should have been used in a different way. “We doubt there will be enough encouragement for 75 per cent of the clinics (to) enrol,” AMA vice-president Julian Rait told The Australian. “Perhaps the government might need to reconsider their strategy after (the policy comes into force).

“We just believe it should have been delivered into the rebates, particularly to develop a new seven-tiered structure that might better support longer consul­tations rather than encourage shorter ones.”

Professor Rait said the current bulk billing system – which would be further “baked in” by the government’s $8.5bn policy – encouraged short, sharp consults that were not in the interest of patients.

“We have concerns that while it might work for some practices, it won’t work for others, hence why there’s been some doubt about whether … all practices would embrace it,” he said.

Questions from the department over whether Labor’s 12.5 per cent incentive split between practices and providers would offer “sufficient incentive” for doctors to join the amended bulk-billing program were seized upon by the Coalition, which accused the Prime Minister of lying to Australians. “Anthony Albanese is starting to look more like a snake oil salesman than the Prime Minister, as he waves his Medicare card around trying to hypnotise Australians into believing their healthcare is free,” opposition health spokeswoman Anne Ruston said.

“Australians know better; their hip pockets tell them differently every time they go to the doctor.”

Senator Ruston, a member of Coalition leader Sussan Ley’s inner circle, said the opposition would “be watching this situation closely to ensure the Prime Minister keeps the promises he made to the Australian public”.

Doctors said Health Department predictions – reported by The Australian – confirmed the incentive program would not lead to marked increases in bulk-billing.

Max Mollenkopf, who works at a small, mixed billing practice in Newcastle, said the government’s bulk-billing rebate “leaves a gap between what it costs us as a practice and as general practitioners to provide a service”.

“It makes no economic sense for us to participate in the scheme,” Dr Mollenkopf said.

Mount Druitt Medical Centre specialist GP Kean-Seng Lim echoed Professor Rait’s view that the incentive encouraged a cycle of increasing short consultations.

“What would really help us in general practice is having access to a really strong primary care team – the allied health, the dietitians, the exercise physiologists, our teams of nurses – and these are not groups benefiting from bulk-­billing incentives,” Dr Lim said.

“What’s needed is good pro­active planned care by the whole team looking after the needs of each individual on a much more individualised basis, which is not what can be done through standard short consultation.“

Labor’s $8.5bn policy aims to lift bulk-billing rates to 90 per cent by 2030 through an increase in the Medicare payment to doctors from $42.85 to an expected $70 for every appointment lasting 20 minutes or less and will come into force from November.

The National Rural Health Alliance said many GPs or primary care practices in regional areas in particular would still be unable to afford to fully bulk-bill services for communities, given high operational costs and a need for longer, more complex consults due to the comorbidity of rural Australians.

Professor Rait also said the policy would have low uptake because it favoured a practice, rather than an individual doctor.